New Indications for Endoscopic Radiofrequency Ablation

Abstract

Radiofrequency ablation (RFA) is a well-established treatment for several benign, premalignant, and malignant disorders. Although the role of RFA has been clearly defined, new indications for luminal and extraluminal applications of endoscopic RFA-directed therapies have emerged. RFA has recently produced promising results in patients with a variety of gastrointestinal and hepatopancreatobiliary pathologies. For example, endoscopic RFA has been used to treat patients with gastric antral vascular ectasia, chronic radiation proctitis, malignant biliary strictures, and ampullary adenomas with intraductal extension. Furthermore, endoscopic ultrasound-guided RFA appears to be an effective, minimally invasive treatment for ablation of solid and cystic lesions-particularly in the pancreas. We review the newer indications for RFA and discuss potential limitations of endoscopic RFA.

Endoscopic ultrasound-guided radiofrequency ablation for pancreatic neuroendocrine tumors and pancreatic cystic neoplasms: a prospective multicenter study

“…EUS-RFA has been developed to try to ensure a better controlled EUS-guided antitumor treatment combining both tumor necrosis and enhancement of the immune response [20 -22]. A recent review of endoscopic RFA reported only early data on EUS-guided RFA in pancreatic tumors and the largest study included only eight patients [20,22]. They concluded that more data about safety, long-term durability, and clinical indications were needed [20].…”

Efficacy and safety of radiofrequency ablation for treatment of chronic radiation proctitis: A systematic review and meta‐analysis

“…Radiofrequency ablation (RFA) provides a potentially safer alternative to the high rate of complications associated with APC for treatment of CRP. Since the advent of RFA for treatment of Barrett's esophagus, the modality's indications have evolved and expanded to include treatment of variety of gastrointestinal and hepatopancreatobiliary pathologies . While RFA has been increasing utilized for a variety of these conditions, there remains a paucity of data evaluating the safety and effectiveness of RFA for the treatment of CRP …”

“…Since the advent of RFA for treatment of Barrett's esophagus, the modality's indications have evolved and expanded to include treatment of variety of gastrointestinal and hepatopancreatobiliary pathologies. 14 While RFA has been increasing utilized for a variety of these conditions, there remains a paucity of data evaluating the safety and effectiveness of RFA for the treatment of CRP. 15 The primary aim of this study was to perform a systematic review and meta-analysis to evaluate the efficacy and safety of RFA for the treatment of CRP.…”

Percutaneous endobiliary radiofrequency ablation for tumor ingrowth causing metal stent obstruction

“…Thus, combination with local therapies has been attempted to improve patients’ survival and quality of life. Radiofrequency ablation (RFA) is a local ablative therapy using heat that leads to coagulative necrosis and local tumor destruction 2,3 . We describe a case of percutaneous endobiliary RFA for recurring bile duct cancer after surgery causing metal stent obstruction.…”